Clínica e Investigación en Arteriosclerosis (English Edition)最新文献

{"title":"Icosapent ethyl: From the REDUCE-IT trial to clinical practice","authors":"Juan Pedro-Botet","doi":"10.1016/j.artere.2025.500820","DOIUrl":"10.1016/j.artere.2025.500820","url":null,"abstract":"<div><div>In addition to low-density lipoproteins (LDL), those containing apolipoprotein (Apo) B and with a diameter less than 70 nm, including the smaller triglyceride-rich lipoproteins, remnant particles, and lipoprotein(a), may independently contribute to atherosclerosis because they also cross the endothelium and penetrate the arterial intima. Although mild/moderate hypertriglyceridemia is a recognized vascular risk factor, only two studies, the Japan EPA Lipid Intervention (JELIS) and the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), using pure eicosapentaenoic acid (EPA) or icosapent ethyl (IPE), the stable ethyl ester of EPA, respectively, rather than a combination of docosahexaenoic acid (DHA) and EPA, have demonstrated a reduction in the rate of cardiovascular events. For this reason, it was deemed appropriate to examine the implications and applicability of the REDUCE-IT study in real-life settings. This analysis suggests a transversal therapeutic approach, based on both LDL cholesterol and triglycerides, for patients at very high cardiovascular risk to achieve an effective prevention. Furthermore, among patients in secondary prevention, treatment with IPE should focus on those with the highest vascular risk (recent acute coronary syndrome, post-infarction, angioplasty, and coronary bypass grafting).</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 ","pages":"Article 500820"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planning of lipid-lowering treatment in atherosclerotic vascular disease. Consensus SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N","authors":"Rosa Fernández-Olmo ,&nbsp;Alberto Cordero ,&nbsp;Armando Oterino ,&nbsp;Agustín Blanco-Echevarría ,&nbsp;David Vivas ,&nbsp;Carlos Escobar ,&nbsp;Emilio Ortega ,&nbsp;Mónica Torres-Fonseca ,&nbsp;Carmen Sánchez-Peinador ,&nbsp;Borja Quiroga ,&nbsp;Vicente Pascual ,&nbsp;Pedro Martínez-Losas ,&nbsp;Daniel Escribano ,&nbsp;María del Mar Freijo ,&nbsp;Rosa María Sánchez Hernández ,&nbsp;Ana Viana ,&nbsp;Román Freixa-Pamias ,&nbsp;Almudena Castro ,&nbsp;Juan José Gómez Doblas","doi":"10.1016/j.artere.2025.500799","DOIUrl":"10.1016/j.artere.2025.500799","url":null,"abstract":"<div><div>In recent years we have been experiencing an advance in lipid-lowering therapies, with the appearance of new drugs that act on the different metabolic pathways, reducing both the levels of cholesterol associated with low-density lipoproteins (LDL-C) containing apoprotein B (ApoB), and vascular risk. However, the results in achieving goals are still scarce, as well as the use of the different therapies that help us to achieve them. Among the reasons that justify this situation are: the inadequate identification of vascular risk, the underuse of therapies, poor adherence to the recommended treatment, the lack of organization in terms of the assignment of roles and algorithms of action in the follow-up of patients and the need for improved education and psychosocial interventions that influence both adherence and consolidation of Healthy lifestyle habits. This consensus document aims to improve the approach and follow-up of dyslipidemia in a comprehensive way, defining the planning of lipid-lowering therapies as a control strategy (SEC/SEA/SEEN/SEMFYC/SEMERGEN/SEMG/SEN/SEACV/S.E.N.).</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 4","pages":"Article 500799"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular prevention studies in a population with hypertriglyceridemia","authors":"Ovidio Muñiz-Grijalvo","doi":"10.1016/j.artere.2025.500819","DOIUrl":"10.1016/j.artere.2025.500819","url":null,"abstract":"<div><div>Although hypertriglyceridemia (&gt;150 mg/dL) has been considered a risk factor for the development of atherosclerotic vascular disease, this relationship is not as linear or robust as that for LDL cholesterol, and the reduction of plasma triglyceride levels has not been consistently related to the reduction of this complication. Thus, in general terms and in the absence of a conclusive clinical benefit, current evidence does not support treatment with fibrates, niacin or omega-3 fatty acids routinely to reduce cardiovascular risk. The recommendation, especially the former, is limited to some subjects already treated with statins and with optimal LDL cholesterol levels in whom elevated triglyceride levels persist. As an exception, only purified icosapent ethyl at a high dose (4 g daily) has demonstrated a reduction in cardiovascular morbidity and mortality and has been authorized for this indication, following the results of the REDUCE-IT trial.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 ","pages":"Article 500819"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence on cardiovascular prevention with icosapent ethyl","authors":"Jose Luis Díaz-Díaz","doi":"10.1016/j.artere.2025.500818","DOIUrl":"10.1016/j.artere.2025.500818","url":null,"abstract":"<div><div>Icosapent ethyl, a highly purified ester of eicosapentoic acid, is the only omega-3 fatty acid authorized by the European Medicines Agency to reduce the risk of cardiovascular events in people at risk, treated with statins and with triglyceridemia ≥150 mg/dL. This authorization comes as a consequence of the clinical benefit observed in the \"Reduction of Cardiovascular Events with Icosapent Ethyl Intervention Trial\", in which icosapent ethyl demonstrated - compared to placebo - a 25% reduction in the relative risk of cardiovascular morbidity and mortality, a result consistent and independent of other variables in prespecified analyses and hypothesis generating in post-hoc analyses of several patient profiles. Although the mechanism of action for such benefit is not definitively established, it is known that it acts at different levels in the continuum of atherosclerotic cardiovascular disease (lipid-lowering, vascular endothelium and membrane protection, anti-inflammatory, atherosclerotic plaque stabilizing and antithrombotic effects) and that final anti-atherosclerotic action in the coronary territory has been demonstrated in the study “Effect of Vascepa on Improving Coronary Atherosclerosis in People With High Triglycerides Taking Statin Therapy”.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 ","pages":"Article 500818"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertriglyceridemia (> 150 mg/dL) as a marker of cardiovascular risk","authors":"José López-Miranda","doi":"10.1016/j.artere.2025.500822","DOIUrl":"10.1016/j.artere.2025.500822","url":null,"abstract":"<div><div>In patients who have achieved optimal LDL-C control, there remains a residual risk of atherothrombotic cardiovascular disease (ASCVD) related to alterations in lipid metabolism, among which alterations in triglyceride-rich lipoproteins and the cholesterol they contain, known as remnant cholesterol, play a major role. Remnant cholesterol is related to ASCVD risk that is independent of LDL-C and has been demonstrated in epidemiological and Mendelian randomization studies. Numerous epidemiological and genetic Mendelian randomization studies support that elevated triglyceride-rich lipoproteins (TRL) and remnant cholesterol are causally associated with ASCVD, myocardial infarction, ischemic stroke, aortic valve stenosis, and all-cause mortality. The remnant particles of triglyceride-rich lipoproteins are highly atherogenic due to their ability to enter and be retained in the arterial wall, their high cholesterol content, and their capacity to generate foam cells, induce endothelial dysfunction, a prothrombotic environment, and a vascular inflammatory response. Assessment of remnant cholesterol can provide information about residual ASCVD risk beyond that provided by LDL-C, non-HDL-C, and apoB, particularly in individuals with hypertriglyceridemia, type 2 diabetes, or metabolic syndrome.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 ","pages":"Article 500822"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of metabolic syndrome on coronary artery severity in patients with acute myocardial infarction: A perspective from a developing country","authors":"Hai Phuong Nguyen Tran ,&nbsp;Tai Nhat Nguyen ,&nbsp;Kha Minh Nguyen ,&nbsp;Sang Quang Ly ,&nbsp;Sy Van Hoang","doi":"10.1016/j.artere.2025.100737","DOIUrl":"10.1016/j.artere.2025.100737","url":null,"abstract":"<div><h3>Introduction</h3><div>Metabolic syndrome (MetS) has been frequently observed in patients with acute myocardial infarction (AMI). However, there is limited research assessing the impact of metabolic syndrome on coronary artery severity in patients with acute myocardial infarction.</div></div><div><h3>Methods</h3><div>We analyzed 199 patients with AMI who underwent invasive coronary angiography. This study aimed to determine the impact of MetS, MetS score and its components on coronary artery severity.</div></div><div><h3>Results</h3><div>The study comprised 199 eligible patients, with an average age of 64.5<!--> <!-->±<!--> <!-->11.3 years. Among the entire cohort, 136 patients (68.3%) were diagnosed with MetS. The MetS 3 subgroup with three components exhibited the highest percentage at 29.2%. The proportion of one-vessel, two-vessel, three-vessel, multi-vessel disease, or left main disease did not differ between the MetS and non-MetS groups (<em>p</em> <!-->&gt;<!--> <!-->0.05). Our study revealed that the MetS group had a higher median Gensini score compared to the non-MetS group (<em>p</em> <!-->=<!--> <!-->0.002). Furthermore, the Gensini score was significantly correlated with the MetS score (Spearman correlation 0.2, <em>p</em> <!-->&lt;<!--> <!-->0.05). Among metabolic syndrome components, elevated waist circumference and elevated blood glucose were associated with the Gensini score.</div></div><div><h3>Conclusions</h3><div>Our study revealed that MetS, MetS score and two components of MetS, elevated waist circumference and elevated blood glucose, were associated with the severity of angiographic coronary artery in patients with AMI.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 4","pages":"Article 100737"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mechanisms underlying the cardiac effects of modified citrus pectin in obese rats with myocardial ischemia: Role of galectin-3","authors":"Sara Jiménez-González ,&nbsp;Beatriz Delgado-Valero ,&nbsp;Ana Romero-Miranda ,&nbsp;Fabian Islas ,&nbsp;María Luaces ,&nbsp;Bunty Ramchandani ,&nbsp;María Cuesta-Corral ,&nbsp;Alejandro Montoro-Garrido ,&nbsp;María Luisa Nieto ,&nbsp;Ernesto Martínez-Martínez ,&nbsp;Victoria Cachofeiro","doi":"10.1016/j.artere.2025.100750","DOIUrl":"10.1016/j.artere.2025.100750","url":null,"abstract":"<div><h3>Background</h3><div>Modified citrus pectin (MCP) is used as a nutritional supplement that inhibits galectin-3 activity, a central player in the cardiac damage associated with different pathological situations. In fact, we have previously observed that MCP improved cardiac function in obese infarcted rats that was associated with a reduction in cardiac fibrosis. Therefore, the aim of the present study was to further explore whether this effect could involve the modulation of gene expression of ECM components and their mediators as well as whether it could affect another two mechanisms involved in cardiac damage: mitochondrial dynamics and autophagic flux.</div></div><div><h3>Methods</h3><div>Male Wistar rats were fed an atherogenic diet with a high content of saturated fat (35%). MI was induced by the ligation of left anterior descendant (LAD) coronary artery 6 weeks after and MCP (100<!--> <!-->mg/kg/day) or vehicle were administered for 4 weeks more. A group of rats fed a standard diet (5.3% fat) and subjected to a sham operation was used as controls.</div></div><div><h3>Results</h3><div>Obese infarcted animals presented an increase in cross-linked collagen that was not affected by the administration of galectin-3 inhibitor. However, MCP reduced the increase in gene expression observed in obese infarcted rats of ECM components and mediators (collagen I, fibronectin, transforming growth factor-β and connective tissue growth factor), of components of endoplasmic reticulum stress (binding immunoglobulin protein, CCAAT-enhancer-binding homologous protein and activating transcription factor 4), of oxidative stress mediator (NADPH oxidase-4) and normalized those of the interleukin 33/ST2 system. MCP is also able to increase the levels of the mitochondrial protein Dynamin-1-like and those of both proteins involved in autophagic flux (p62 and LC3) that were reduced by the myocardial ischemia in the context of obesity.</div></div><div><h3>Conclusions</h3><div>The data show that the beneficial effect of the nutritional supplement MCP on the cardiac consequences associated with myocardial ischemia in the context of obesity could rely on its capacity to inhibit galectin-3 and to consequently modulate different downstream mechanisms, including inflammation, ER stress, oxidative stress, autophagy and mitochondrial function, which can facilitate fibrosis and cardiac remodeling in this pathological context.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 4","pages":"Article 100750"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of hypertriglyceridemia to reduce cardiovascular risk","authors":"Carlos Guijarro Harráiz","doi":"10.1016/j.artere.2025.500816","DOIUrl":"10.1016/j.artere.2025.500816","url":null,"abstract":"","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 ","pages":"Article 500816"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency of fixed-dose combinations of statin and ezetimibe in the treatment of hypercholesterolemia","authors":"Carlos Guijarro ,&nbsp;Angel Diaz ,&nbsp;Eva Moreno ,&nbsp;Paula Gamonal ,&nbsp;Maria Soler ,&nbsp;Neus Vidal-Vilar ,&nbsp;Maria Rosa Fernandez","doi":"10.1016/j.artere.2025.500753","DOIUrl":"10.1016/j.artere.2025.500753","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the clinical and economic benefits derived from increasing the use of fixed-dose combinations of high-intensity statins and ezetimibe in patients at high/very high cardiovascular risk, from the perspective of the Spanish National Health System (SNS).</div></div><div><h3>Methods</h3><div>A baseline scenario (current market shares) was compared with scenarios that increased the use of fixed-dose combinations (alternative: 30% increase; optimized: 69% increase). The potential annual increase in the number of controlled patients, cardiovascular events avoided and the associated savings in direct medical costs were estimated, including the cost of pharmacological treatment, follow-up, and managing cardiovascular events over a three-year time horizon.</div></div><div><h3>Results</h3><div>Over the three years of the study, the baseline scenario estimated a total of 1,552,686 controlled patients and 39,449 cardiovascular events, with a total cost to the NHS of €1,841,057,122. In the alternative scenario, controlled patients would increase by 36.1%, and 139 cardiovascular events would be avoided, resulting in savings for the NHS of 36,116,631 €. In the optimized scenario, there would be a 64% increase in controlled patients and 250 CV events would be avoided, leading to savings of 56,415,300 € for the NHS.</div></div><div><h3>Conclusion</h3><div>Increased use of high-intensity statin and ezetimibe fixed-dose combinations in patients with high/very high CV risk may increase the number of controlled patients, reduce CV events and produce economic savings from an NHS perspective.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 3","pages":"Article 500753"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between sociodemographic variables, healthy habits and stress with diabesity","authors":"Ángel Arturo López-González ,&nbsp;Emilio Martínez-Almoyna Rifá ,&nbsp;Hernán Paublini Oliveira ,&nbsp;Cristina Martorell Sánchez ,&nbsp;Pedro Juan Tárraga López ,&nbsp;José Ignacio Ramírez-Manent","doi":"10.1016/j.artere.2025.500754","DOIUrl":"10.1016/j.artere.2025.500754","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabesity is a pathological condition that combines obesity and type 2 diabetes in the same individual. Due to the current rise in both conditions, the prevalence of diabesity is increasing worldwide. Its etiology is known to be multifactorial; therefore, the aim of this study is to understand how diabesity is associated with various sociodemographic variables, healthy habits, and stress.</div></div><div><h3>Materials and methods</h3><div>A descriptive, cross-sectional study was conducted on 24,224 Spanish workers to evaluate the association between diabesity and various factors such as age, gender, socioeconomic status, smoking, alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress. The criteria used to define diabesity included body mass index (BMI), body fat (BF), and visceral fat (VF).</div></div><div><h3>Results</h3><div>All the aforementioned variables were found to be associated with diabesity. The highest odds ratios (OR) were observed for age, with values ranging from 5.57 (95% CI: 4.48–6.67) when BF was used as the diabesity criterion to 6.89 (95% CI: 5.60–8.19) when VF was the criterion. Similarly, elevated ORs were observed for male gender, with ORs of 6.77 (95% CI: 5.31–8.24) for VF and 3.34 (95% CI: 2.77–3.94) for BF.</div></div><div><h3>Conclusions</h3><div>In our study, the profile of a person at highest risk of diabesity is a man over 50 years old from a lower socioeconomic status, who is a smoker, regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high stress levels.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 3","pages":"Article 500754"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}